From the Guidelines
It is strongly recommended to avoid drinking alcohol while taking terbinafine due to the increased risk of liver problems and potential intensification of common side effects. Terbinafine is an antifungal medication used to treat infections like athlete's foot, ringworm, and nail fungus, and combining it with alcohol can put additional strain on the liver, which processes both substances 1. Terbinafine itself carries a small risk of liver damage as a side effect, and alcohol consumption can compound this risk. The British Association of Dermatologists' guidelines for the management of onychomycosis 2014 recommend baseline liver function tests and a complete full blood count in patients with a history of heavy alcohol consumption, hepatitis, or haematological abnormalities before starting terbinafine treatment 1. Additionally, drinking alcohol while on terbinafine may intensify common side effects such as headache, stomach upset, and dizziness. For the safest treatment course, you should abstain from alcohol during your entire terbinafine treatment period, which typically ranges from 2 weeks for skin infections to 6-12 weeks for nail infections. If you've already consumed alcohol while taking terbinafine, monitor for symptoms like unusual fatigue, yellowing of skin or eyes, dark urine, or abdominal pain, which could indicate liver issues requiring immediate medical attention. Some studies suggest that moderate alcohol consumption may be safe for certain individuals, but in the context of terbinafine treatment, it is best to err on the side of caution and avoid alcohol altogether 1. Key points to consider include:
- Terbinafine and alcohol are both processed by the liver
- Combining terbinafine and alcohol can increase the risk of liver problems
- Terbinafine carries a small risk of liver damage as a side effect
- Alcohol consumption can compound this risk
- Drinking alcohol while on terbinafine may intensify common side effects
- Abstain from alcohol during the entire terbinafine treatment period
- Monitor for symptoms of liver issues if alcohol has been consumed while taking terbinafine.
From the Research
Drinking Alcohol while Taking Terbinafine
- There is no direct evidence in the provided studies that specifically addresses the interaction between drinking alcohol and taking terbinafine.
- However, studies have shown that terbinafine can cause hepatic reactions, including reversible hepatic damage 2, 3.
- The risk of hepatic damage is rare, but patients should be advised to inform their physician if any warning symptoms are noticed 2.
- Laboratory monitoring of liver function tests is not recommended for patients taking terbinafine, but patients should be advised to discontinue treatment and seek medical care if symptoms of liver injury occur 3.
- Other antifungal agents, such as ketoconazole, itraconazole, and fluconazole, have been shown to cause hepatic toxicity, ranging from mild and asymptomatic abnormalities in liver function tests to substantial liver injury and fulminant hepatic failure 4, 5.
- A study comparing the hepatotoxicity of antifungal agents found that terbinafine had a lower risk of causing liver injury compared to ketoconazole, itraconazole, and fluconazole 5.
- Another study found that terbinafine did not have a significant effect on the metabolism of cyclosporin by human liver microsomes, suggesting a lower potential for interaction with other drugs 6.